IGeL Services: Benefits, Risks, and Making the Right Decision

IGeL: Between Freedom of Choice and Uncertainty

You may have experienced this before: during a doctor’s visit, you are offered an additional examination or treatment that you have to pay for yourself – such as an ultrasound for early detection or a special laboratory test. Such services are referred to as Individual Health Services, known as IGeL for short. They supplement standard medical care and give patients the option to use services that go beyond what is covered by statutory health insurance. But what exactly lies behind IGeL services? How are they created – and what should you pay attention to when they are offered?

What are IGeL services, and how do they work?

Individual Health Services are medical offerings provided in doctors’ practices in addition to standard care and are not part of the benefit catalog of the German statutory health insurance (GKV). This means that these services are generally paid for by patients themselves. Statutory health insurance in Germany generally covers the costs of all medically necessary treatments – with a few exceptions, such as co-payments for medications, hospital stays, or dental prostheses. IGeL services are often aimed at people who are interested – beyond standard care – in preventive measures, diagnostics, or therapies that may be individually beneficial.

However, it is important to know this: some statutory health insurance funds voluntarily cover the costs of certain IGeL services under specific conditions – for example, as part of bonus programs or individual contracts. It is therefore worthwhile to check with your own health insurance provider before using such a service to see whether the costs may be covered.

Common Services and Examples from Medical Practice

The range of individual health services is broad, spanning diagnostic examinations, therapeutic measures, and health-related service offerings. Which specific services are offered depends largely on the medical specialty and the practice’s focus.

Frequently offered IGeL services include ultrasound examinations for early cancer detection, certain laboratory analyses, and measurement of intraocular pressure for early glaucoma detection. Acupuncture for chronic pain is also included. In addition, there are services offered in special life situations – for example during pregnancy or in the case of chronic illnesses.

Some services are not fundamentally medically necessary, but may be relevant depending on an individual’s personal situation. These include medical certificates, sports medicine examinations, travel vaccinations, psychotherapeutic services such as couples or family therapy, as well as medical-cosmetic procedures such as tattoo removal or minor aesthetic corrections.

Under certain circumstances – for example, if there is a specific suspicion of disease – an examination initially offered as an IGeL service may also be covered by statutory health insurance. In such cases, a medical necessity exists, meaning that the service falls under the statutory health insurance benefit catalog.

Why Are Some Services Not Covered by Health Insurance?

Which services are covered by statutory health insurance is decided by the German Federal Joint Committee (G-BA). This decision is based on scientific evidence as well as legally defined criteria such as medical necessity, effectiveness, and cost-effectiveness. Only if the benefit of a service is well substantiated and it has a reasonable balance between effort and risks is it included in the benefit catalog. Services for which such evidence is still lacking, or that primarily serve individual health prevention, are therefore offered as IGeL services.

Benefits and Risks: What Do Scientific Evaluations Say?

Not every IGeL service is automatically effective or necessary – at the same time, it is not inherently useless either. The IGeL Monitor of the Federal Medical Service (MD Bund) evaluates various services based on scientific criteria and provides guidance for patients. According to the IGeL Monitor, some services show positive potential, while others are assessed critically – for example because they often lead to false-positive results or because their benefit has not yet been clearly demonstrated. Individual counseling and information are therefore particularly important.

Criticism and Discussion Surrounding IGeL Services

IGeL services are criticized not only because of scientific uncertainties, but also with regard to costs and the information provided to patients. Consumer advocates and health experts criticize that patients are often not sufficiently and neutrally informed about the benefits and risks. Financial interests of individual doctor’s offices are also mentioned in the public debate. However, it is important to note: many physicians handle the offering of IGeL services responsibly and genuinely aim to provide patients with additional individualized options. It is therefore important to view these services in a differentiated way and not to generalize prematurely.

If you are unsure whether an IGeL service was explained to you sufficiently and clearly, or if you have doubts about the appropriateness of the offer, you can contact the German Consumer Advice Center (Verbraucherzentrale). Via the online portal “IGeL-Ärger”, you have the opportunity to describe your concern, submit complaints, and obtain further support.

How Can You Decide Whether an Igel Service Makes Sense for You?

A good decision is based on clear knowledge of the benefits, risks, and alternatives. Information from independent, evidence-based sources such as the IGeL Monitor helps you realistically assess the medical value of a service. The Independent Patient Advice Service in Germany (Unabhängige Patientenberatung Deutschland, UPD) also provides reliable information.

Among the practical recommendations of the IGeL Monitor are: inform yourself about potential IGeL services before your doctor’s appointment and consider which questions are relevant for you. If an IGeL service is suggested to you during the consultation, ask to have its benefits and risks explained to you calmly and in detail. Under the Patient Rights Act of the German Civil Code (§ 630c BGB), physicians are required to provide you with comprehensive and understandable information about costs, benefits, and alternatives. Ask for a written cost estimate and a written agreement for the service – this protects both parties and ensures transparency. Take enough time to make your decision, and do not hesitate to seek a second opinion.

Conclusion: Between Individual Freedom and Medical Responsibility

IGeL services can be useful, for example when it comes to specific preventive examinations that are personally relevant to you. However, scientific evaluations of many IGeL services show that not everything that is offered is necessarily beneficial. What matters most for you as a patient is an informed decision based on proven benefits and a realistic assessment of possible risks. Use trusted sources and speak with your physician to determine which service may truly be appropriate in your individual case.

Sources

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Individual Health Services (IGeL)